Economic Implications of Potential Drug–Drug Interactions in Chronic Pain Patients

Robert Taylor Jr; Joseph V Pergolizzi Jr; R Amy Puenpatom; Kent H Summers

Disclosures

Expert Rev Pharmacoeconomics Outcomes Res. 2013;13(6):725-734. 

In This Article

Relationship Between DDEs & Cost

Literature support for the economic impact of DDEs and DDIs are lacking, but do suggest they cause a greater cost utilization of health care resources. For example, in a study using a prescription claims database to analyze DDIs in HIV therapy-treated patients, DDIs were significantly associated with greater hospital costs.[36]

Did the increased utilization of health care services lead to higher costs? These database studies found that patients with DDEs were associated with significantly higher total payments (medical plus prescription drug costs) (Table 2).[29–31] Subjects with DDEs had significantly greater total 6-month health care costs (difference of US$667) and analysis of specific chronic pain populations also yielded similar results. For example, the total payment differential associated with DDEs was US$763 and US$733 (for older and younger cLBP patients, respectively) and US$1207 and US$1087 (for older and younger OA patients, respectively) for 6 months.

The higher total 6 month payments were mainly driven by the differences in both medical and prescription costs (Table 3) Noncancer pain patients with DDEs had significantly greater total 6-month medical costs ($5520 vs $5222, respectively, p < 0.0001) and total prescription costs ($2646 vs $1159, respectively, p < 0.0001) than subjects with no DDE. When individual pain populations were analyzed, similar results were observed. The total medical payment (office visits, outpatient visits, ED visits and inpatient hospitalizations) difference at 6 months associated with a DDE was $257 and $576 for younger and older cLBP patients, respectively, and $601 and $1,070 for younger and older OA patients, respectively. Total prescription payment difference associated with a DDE was $476 and $196 for younger and older cLBP patients, respectively, and $486 and $137 for younger and older OA patients, respectively. Reasons for increased prescription costs caused by DDEs could be due to additional adjuvant therapies for side effect or new disease management, increased doses due to loss of efficacy and/or switching to other more expensive analgesics to avoid potential DDEs and side effects.[37]

For the younger population in both the OA and cLBP studies, higher total costs associated with DDEs were mainly associated with increased prescription costs (Table 3). Differences in total 6 month medical costs between younger patients with DDEs versus no DDEs were not statistically different. The higher prescription costs in younger patients suggest higher rates of polypharmacy, which is directly related to the prevalence of DDEs as explained below.

Comments

3090D553-9492-4563-8681-AD288FA52ACE

processing....